High School Application - JBL Scholarship

High School Graduate Application

Step 1 of 5

High School Student Application for the 2021-2022 Academic Year
Name*
First M.I. Last
Email Address*
Date of Birth*
Sex
Permanent Address (No P.O. Box)*
Street Address Address Line 2 City State ZIP Code
Phone Number*
Parent or Legal Guardian Name*
First Last
Parent or Legal Guardian Address*
Street Address Address Line 2 City State ZIP Code
Parent or Legal Guardian Phone*
2nd Parent or Legal Guardian Name (if applicable)
First Last
2nd Parent or Legal Guardian Address (if applicable)
Street Address Address Line 2 City State ZIP Code
2nd Parent or Legal Guardian Phone (if applicable)
Name of High School*
Address of High School*
Street Address Address Line 2 City State ZIP Code
Graduation Year*
GPA*
SAT Score
Use only numbers for this field.
ACT Score
Use only numbers for this field
State the names of the colleges which have accepted you in the space below:
State the name and address of the college you plan to attend:
If you are undecided on the college you plan to attend, list two or three schools that you are considering most seriously in the space below:
State your school-related extracurricular activities in the box below. Include school-sponsored or affiliated activities (e.g., student government, sports, yearbook, dramatics, special interest clubs, etc.) which are not required as part of the normal academic program. Indicate the length of time and level of your involvement (member, officer, organizer, etc.). State the name and title of a faculty member who is in a position to evaluate your participation.*
State the non-school-related activities in which you participate (e.g., youth groups, charitable or community organizations, church work, employment, or independent activities). Indicate the length of time you have been involved and any notable accomplishments. State the name, address and title of a person who is in a position to evaluate your involvement and accomplishments.*
Describe any special honors, achievements or awards that you have received.*

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Personal History
Parents (select all that apply):*
- Living
- Deceased
- Separated
- Divorced
List the number of brothers and/or sisters you have and their ages (please type N/A if not applicable):*
State the total annual gross income of your parents, including wages, pensions, interest, dividends, rents received and all other sources:*
First Parent's (or legal guardian's) Occupation:*
Job Work or title:*
Company Name*
Company Address:*
Street Address Address Line 2 City State ZIP Code
Second Parent's Occupation:*
Job Work or title (type N/A if not applicable):*
Company Name (type N/A if not applicable):*
Company Address:
Street Address City State ZIP Code
State any special financial and/or other circumstances that should be considered by the Trust in evaluating your application for a grant:*

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Expenses
State the expenses you expect to incur in the 2021-2022 academic year in attending the college of your choice, including the amount anticipated for each of the following:
College (If undecided, list expenses for first or second choice.)*
Tuition:*
Room and Board:*
Books and supplies:*
Fees:*
Transportation to and from school:*
Other expenses (if none expected, please enter "0"):*
Itemize other expenses below (please type N/A if not applicable):*
TOTAL Expenses:*
Funding
State the sources and amounts of your educational FUNDING for the 2021-2022 academic year, as follows:
From your parent(s) or legal guardian(s):*
From your savings:*
From your earnings:*
From loans:*
Please list the name and address of each bank or foundation lender and the amount of each loan (type N/A if not applicable):*
From scholarship grants:*
Please state the name and address of each grantor and the amount of each such grant (type N/A if not applicable).*
From other sources:*
Please describe your "other" sources (type N/A if not applicable):*
Total estimated funding for the 2021-2022 academic year:*
If your estimated educational funding and expenses for the 2021-2022 academic year are not within $500, explain how you plan to make up the difference (please type N/A if not applicable).*
Selecting a college is one of the most important decision-making processes in which you have been involved, and it may have a significant effect on your future. Assuming that you have now made your college selection or narrowed your search considerably, describe the features or characteristics of the college selected that were of primary importance in your decision. Explain the positive features of the college you have selected, and the negative features, if any, that may concern you.*

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Attachments
Current academic transcript:
Accepted file types: pdf, docx, gif, png.
Personal Letter of Reference #1:
Accepted file types: pdf, docx, doc.
A Letter of Recommendation from an authorized person at your High School:
Accepted file types: pdf, docx, doc, gif, png.
A personal essay:
Accepted file types: pdf, docx, doc, gif, png.
Essays should describe your academic and personal goals, summer and/or any employment experience, and/or something about yourself.
A small personal photograph:
Accepted file types: pdf, jpg, png, docx, gif.
If selected, may we use your essay for publication on the JBL website?*
- Yes
- No

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Signature
I hereby request a grant from the J.B.L. Scholarship Trust, Inc. for the 2021-2022 academic year in the amount of (our usual grant is less than $2,000):*
I certify that, to the best of my knowledge and belief, the information stated above is complete and accurate.*
Today's Date:*
Date Format: MM slash DD slash YYYY
Signature*
Please Note Carefully
Fill in your name, student ID and provide your signature where indicated on Part II of the application before submitting it to your school for completion. (Part II is available on the next page.) Parts I and II must be received at J.B.L. Scholarship Trust, Inc. by March 15, 2021.

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High School
Application

Check the requirements before filling out this form.

High School Graduate Application

Step 1 of 5

High School Student Application for the 2021-2022 Academic Year

Personal History

Expenses

State the expenses you expect to incur in the 2021-2022 academic year in attending the college of your choice, including the amount anticipated for each of the following:

Funding

State the sources and amounts of your educational FUNDING for the 2021-2022 academic year, as follows:

Attachments

Signature

Please Note Carefully

Ready to apply?

JBL

High SchoolApplication

Check the requirements before filling out this form.

High School Graduate Application

Step 1 of 5

High School Student Application for the 2021-2022 Academic Year

Personal History

Expenses

State the ​expenses ​you expect to incur in the 2021-2022 academic year in attending the college of your choice, including the amount anticipated for each of the following:

Funding

State the sources and amounts of your educational ​FUNDING for the 2021-2022 academic year, as follows:

Attachments

Signature

Please Note Carefully

Ready to apply?

JBL

High School
Application

State the expenses you expect to incur in the 2021-2022 academic year in attending the college of your choice, including the amount anticipated for each of the following:

State the sources and amounts of your educational FUNDING for the 2021-2022 academic year, as follows: